Designed to provide base-level health care access to low-income families, as well as the disabled, Medicare is administered by each state in collaboration with the Department of Health and Human Services. Created in 1965 as part of the Social Security Act, the program funds a wide range of state-based programs, including SCHIP (Children’s Health Insurance) as well as other state-level initiatives.
Often times, people confuse the program with Medicare, which is a federal program for disabled individuals over 65; enrollment in Medicaid, by contrast is entirely a function of need, as determined at the state level. Poverty levels are determined by each state, which sets the requirements for enrollment; priority is given to families, pregnant women, the disabled and seniors, although anyone can apply for enrollment. Recent changes in federal policy limit the type of core provided to seniors, especially in terms of private nursing home coverage.
With nearly 50 million individuals enrolled, the program is highly contingent on Federal funding, which helps to supplement state-level budgets. Recent legislation has adjusted the fee structure so that recipients have to pay a co-pay, much as private insurance patients would. Going into the Obama administration, many observers expect the program will be overhauled and expanded to provide coverage to the uninsured, nearly half of whom decline to enroll under a voluntary structure.
